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Sewell to meet with state legislators on healthcare

Brandon Moseley

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Congresswoman Terri Sewell, D-Selma will meet with state legislators and health care stakeholders in Montgomery Wednesday about making health care more affordable and innovative in Alabama.

Sewell is hosting a bipartisan group of state legislators and health care stakeholders to discuss ways to shore up rural hospitals, improve health care affordability, access and quality and innovate Alabama’s Medicaid program to better meet the health needs of constituents across the state.

Sewell is convening the meeting as Alabama faces a rural hospital crisis and just over a week before Butler County’s Georgiana Medical Center is scheduled to close. Georgiana will become the 13th Alabama hospital to close in eight years, and the seventh rural hospital to close its doors, resulting in hundreds of lost jobs and reduced health care access for area residents. At the same time, Alabama residents have some of the poorest health outcomes in the country.

Sewell says that she is gathering leaders to help jumpstart the innovative changes needed to improve health care access, affordability and outcomes.

Medicaid expansion is likely to be a major topic of discussion.

Then-Gov. Robert Bentley (R) rejected Medicaid expansion when President Barack Obama (D) first implemented the Patient Protection and Affordable Care Act. Republicans promised to repeal Obamacare, and presumably the Medicaid expansion; but those efforts failed when moderate Republican Senators Lisa Murkowski (Alaska), Susan Collins (Maine), and John McCain (Arizona) joined with Senate Democrats to defeat Republican efforts to repeal and replace Obamacare.

Alabama did not expand Medicaid and no Republican healthcare plan ever passed Congress; and now that Democrats have retaken the U.S. House of Representatives it is unlikely that a bipartisan plan would ever roll back the Medicaid expansion; even though Medicare and Medicaid are costing the federal government over a $trillion a year, by far the largest budget item in the federal budget.

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Alabama Democrats and the Alabama Hospital Association are mounting a strong push for the legislature to revisit expanding Medicaid to poor, non-disabled adults. Currently, Alabama Medicaid insures only poor children, pregnant women, the disabled, nursing homes residents and seniors. Even so, Medicaid is by far the costliest item in Alabama’s general fund budget.

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There is conservative opposition to expanding the entitlement program and increasing the burden on the state government to provide matching funds for expanding the incredibly expensive program.

The future of rural hospitals is likely grim. Most of rural Alabama is in population decline; thus the rural hospitals serve fewer and fewer customers. On top of that, a lot of doctors are aging out of the profession and the number of new doctors graduating from medical schools is not keeping up with the demand. The competition for young doctors has never been greater and it is difficult for Alabama to recruit young doctors already.  It is very difficult for rural hospitals to make competitive offers, given their already struggling finances and the fact that in many cases a rural medical practice will see less patients than a practice in a suburban or urban community. Many specialists already can’t locate in much of rural Alabama; because there simply are not enough patients there.

Most of the rural hospitals are operating in the red. The hospitals claim they need expansion to decrease the number of customers who receive emergency treatment and then are unable to pay for the treatment.

Some legislators have suggested that many of these struggling hospitals are doomed anyway given demographic change and the state’s growing doctor shortage and a more realistic option would be to develop emergency transportation options for patients in need to get them to treatment in the large urban areas faster.

Sewell represents Alabama’s 7th Congressional District.

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